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Macro creatine kinase type 2: a marker of myocardial damage in infants?
Insights
This study reports an atypical creatine kinase (CK) band in pediatric myocarditis cases. This band, identified as an oligomeric form of mitochondrial CK, may indicate severe heart muscle damage and myocardial necrosis in children.
Area of Science:
- Biochemistry
- Pediatric Cardiology
- Enzymology
Background:
- Myocarditis in infants presents diagnostic challenges.
- Creatine kinase (CK) isoenzyme patterns are crucial in diagnosing cardiac conditions.
- Atypical CK isoenzyme bands can indicate unique pathological processes.
Observation:
- Two infants with myocarditis exhibited an unusual band in their serum CK isoenzyme electrophoresis.
- This atypical band demonstrated distinct electrophoretic mobility and higher molecular mass.
- Immunoglobulin binding assays and CK-BB radioimmunoassay (RIA) helped characterize the band.
Findings:
- The atypical band was identified as an oligomeric form of mitochondrial CK.
- In one patient, the band's reduction correlated with clinical improvement.
- The other patient, showing the band, unfortunately, died shortly after admission.
Implications:
- The oligomeric form of mitochondrial CK may be released during severe myocardial damage.
- This finding suggests a potential biomarker for pediatric myocardial cellular necrosis.
- Further research can explore the diagnostic and prognostic value of this atypical CK form.
Abstract:
The case histories of two children (aged two months) affected by myocarditis showing an atypical band of serum creatine kinase (EC 2.7.3.2; CK) in the CK isoenzyme electrophoretic pattern are reported. The electrophoretic mobility on cellulose acetate of the atypical iso-CK band and its greater relative molecular mass, the lack of binding with immunoglobulins and the result of CK-BB determination by RIA, allowed us to identify the band with an oligomeric form of the mitochondrial isoenzyme. One child died 2 days after admission, while in the other it was possible to demonstrate reduction and disappearance of the atypical band in concomitance with a marked clinical improvement. Our findings suggest that the oligomeric form of mitochondrial-CK is released in conditions of serious heart muscle damage, and that it may be an indicator of myocardial cellular necrosis in pediatric patients.